The federal government would have more power to oversee pharmacy benefit managers under a bipartisan bill introduced in the U.S. Senate.
The Pharmacy Benefit Manager’s (PBM) Oversight Act of 2023, sponsored by Sen. Tom Carper, D-Del., and Sen. Chuck Grassley, R-Iowa, would give the Centers for Medicare and Medicaid Services the authority to oversee PBM decision-making. It also would require that PBMs submit detailed information to CMS each year that includes documentation of their interactions with recommendation committees, which are the groups that decide on what will be included in a formulary.
“Far too many Americans are forced to make the impossible decision of choosing between putting food on the table and paying for the medications that they need,” Carper said. “This is unacceptable. This bipartisan legislation will take a critical step forward toward rooting out the causes of the high costs for lifesaving medications. By holding pharmacy benefit managers accountable and establishing much-needed oversight of their practices, we will bring American patients back to the forefront of our medical system.”
PBMs also would be required to submit information about what drugs were selected and a justification for the decisions. The Government Accountability Office then would be tasked with studying this information and reporting its findings to Congress.